Dyspnea, Chest Pain, and Altered Mental Status in a 33-Year-Old Carpenter

Thyroid Storm Due To Head Injury

“…Although TSH is generally undetectable, a low thyrotropin (TSH) level also supports the diagnosis. [3] In the case presented here, it seems that a pre-existing and untreated abnormality of the thyroid gland was responsible for the clinical picture. On the basis of this constellation of findings, the most likely diagnosis was thyroid storm, precipitated by trauma, in a patient with pre-existing hyperthyroidism.…”

“…[3] There are few case reports in literature, which mention trauma as a precipitating event of thyroid storm. [5] The incidence is <10% of the patients interned to hospital for thyrotoxicosis, and it is generally related to a precipitating event, such as comorbid conditions, infec-tion, thyroid or non-thyroidal surgery, pulmonary embolism, pre-eclampsia, emotional stress, or withdrawal of anti-thyroid medications.…”

“…However, aspirin should be avoided as it induces decreased binding of T3 and T4 to thyroxine-binding globulin. [3] Treatment with paracetamol, as an alternative drug, can be useful without side-effects.…”

“…[2] Thyroid storm symptoms and signs may vary and are mainly non-specific due to the widespread effects of thyroid hormones. [3] For the limitation of mortality and morbidity, early diagnosis and treatment are essential.…”

Emotional Stress-Induced Thyroid Storm

“…The thyroid storm is a life-threatening complication of thyrotoxicosis with high mortality rate. 6 There are few reported cases in the literature that mentions emotional stress being a risk factor for thyroid storm. 4 The progression of thyrotoxicosis to thyroid storm cannot be predicted.…”